706 32ND ST 2023-04-07 - Laserfiche WebLink

• mum Limml PLRIBING PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS:Drop off hard copy completed paper application to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 70( 32„d S. PARCEL#: CrrY g/vk T. STATE W4 ZIP SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: VID Fiji f/ U1t/ OWNER MAILING ADDRESS: STREET /06 32nd Sa CITY Ev€-12.671' STATE ZIP OWNER PHONE: dZnb qq0 5121 OWNER EMAIL: da ijd, }-c+n k,l i qma'I .L6n'1 CONTRACTOR COMPANY NAME: 5 .r Z� 2k vvr0bl r1 \J WA STATE CONTRACTOR LICENSE#(I5 I G t 25,1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5 S int, CONTRACTOR ADDRESS: STREET 15611 Lti 1J I C. CITY S noh oW1 t 5 k STATE WA ZIP CONTRACTOR PHONE: 3 600-S 66- '1 7 CONTRACTOR EMAIL: (, �o ��Ivrrr�v1r� t(rpm PRIMARY CONTACT: XOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: • 12 "_2 3f., 8 5� ,rUct C,1,ri6 e e - CONTACT EMAIL: C -akar, C:dn�'�l'1JlCf')o krittw,1cow, PLUMBING PERMIT INFORMATION VALUATION OF WORK:$ 4.00 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: Alt* ei Mb•'G: kb() PLUMBING PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (QtY) (QtY) Backflow Prevention Device(Inside Building)-select devices below: i Shower,Tub,or Combo Fire Service:❑DCDA, Domestic Service:❑RPBA❑DCVA Commercial Sink(3-compartment,prep,floor) I Clothes Washer '. Residential Sink(kitchen,bath,bar) I Dishwasher Utility Sink(laundry,mop) Drinking Fountain Toilet 1 Floor Drain Urinal I Hose Bibb Waste/Water Pipe Repair Ice Maker Water Service Line(Behind meter,private side) Grease Interceptor Water Valves/Fixtures Sand/Oil Interceptor Water Heater-Electric Medical Gas I Water Heater-Gas Roof Drains Other(List Type): Sewage Ejector Pump/Sump Pump Other(List Type): ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT lry2. 450 Vat Owner/Authorized Agent Signature Date (Revised 2/8/2021)